Workplace wellness programs are becoming more commonplace as employers look to reduce skyrocketing health care costs for themselves and their employees. The wide range of programs available can result in various outcomes, from simply educating employees to achieving significant health care cost savings.

"Virtually all employers in surveys — 90 percent — say they have a wellness program," said Bill Mauke, partner and workforce health practice leader at Ovation Benefits Group in Farmington. "But they are all over the board in terms of what they offer."

Programs range from those which include educational materials to increase awareness of risk factors, to events and activities that encourage employees to get active or eat better, to detailed health screenings and specific programs that cater to an at-risk population.

Mauke said employers need to know what they're expecting out of a wellness program before it's implemented.

"Health-related costs are the second or third leading line item on anyone's budget," he said. "Most employers want to know, 'Is this going to help me reduce my costs?'"

A driving force behind all health care costs is several chronic diseases and conditions, many of which are related to behavior and lifestyle. These include heart disease, diabetes, high blood pressure, high cholesterol, obesity and certain cancers.

"The trick is to find people at risk for these conditions before they have an episode that will cost a lot of money," Mauke said.

In order to determine who is pre-disposed for certain conditions or at-risk for a serious episode such as a stroke or a heart attack, effective wellness programs utilize confidential health risk assessments and biometric measures to determine whether employees may acquire these conditions if their health is not managed.

"For most employers, these conditions are responsible for 75 percent of their total health care expenditures," Mauke said. "And what we have seen in doing about 100,000 screenings for employers is that it's generally about 15 percent of their population that is at high and immediate risk for these kinds of diseases."

Employers already spend about $10,000 a year, on average, for every employee covered under their health plan. But, Mauke said, many of them aren't considering what they are getting for what they are spending.

"In an effective employee wellness plan, it will have been able to reduce annual cost increases on health care from 12 percent to 3 percent — that's an excellent outcome," he said. "They also find when they look more broadly, they're able to see substantial decreases in absence and disability costs. When you look at the impact on health holistically, it's a big number."

Without wellness programs, Mauke said employers can expect to pay an additional 10 to 15 percent more each year in health care costs.

"No employer can afford to do that," he said. "It's good news for employers that are doing this. They can stop reducing benefits to employees and keep the quality of the plans they offer higher."

Barbara Aiudi, vice president of employee benefits at C.M. Smith Agency in Glastonbury, said in addition to offering an effective wellness program, employers also need to make sure their policies help improve employee health.

"From a benefit plan design perspective, we look at policies and procedures to make sure they're aligning appropriately so they don't contradict what they do," she said. "So, if they're offering a program to quit smoking, they should have a 'no smoking' policy for employees."

Aiudi said many employers start small when it comes to wellness, and gradually build up to more intensive programs. She said the staged approach is often effective in the long run.

The first kind, which focuses on team building and employee awareness, is a good introduction to wellness. "You will typically see a minimal return on the investment in that program but it helps build morale," she said.

From there, many employers work towards promoting wellness types of activities, such as walking or hiking programs, before launching a comprehensive health model with health risk assessments.

"The third type is the most effective," she said. "Studies show that for the most comprehensive programs, you see for every dollar spent, you get $3 to $6 back."

Aiudi stressed that employers need to thoroughly research employees' health concerns, typically through a third party to ensure confidentiality, in order to create the most effective program.

"You can throw a lot of resources at it, but if you don't identify the appropriate resources for a given population, it might not bring value to you," she said.

Aiudi offers an example a smoking program for an employee population not yet ready to quit smoking.

"You have to know what behaviors people are ready to change," she said.

"We work with them to design the kinds of things that may be unique to their employee set," Fishman said. "It's broad and can really be put together to address their needs. We want to be flexible."

Fishman and Lisa Marzoli, wellness coordinator for Anthem Blue Cross Blue Shield, said the most effective workplace wellness programs are supported by both employees and management.

"It needs to be easily and broadly accessible to employees," Marzoli said. "If someone has three shifts, you want to make sure all shifts have access to services. They should also have some feedback tool to see how it's going."

Fishman said working with insurers on wellness initiatives is an ideal way to track data.

"We know what the claims information is, so we can tell you what percentage of your employees has diabetes or high blood pressure," she said. "A big piece of wellness is identifying people with chronic diseases and getting them healthy. It's not just disease prevention but disease improvement."